Center for Integrated Behavioral Health, LLC

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

Legal business name

CENTER FOR INTEGRATED BEHAVIORAL HEALTH, LLC

Practice address

10473 Old Hammond Hwy
Baton Rouge, LA 70816-8264

Phone

(225) 924-1910

Fax

(225) 924-1988

NPI assigned

Mar 7, 2017

Organization subpart

Yes

Parent organization

WOODLAKE MANAGEMENT, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Randal A Gomez

Title

Ceo

Phone

(225) 933-9000

Specialties & licenses 3

Addresses

Part of

Woodlake Management LLC

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Woodlake Management, LLC

  dba Woodlake Addiction Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Ethel, LA
  • NPI 1053648774
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1396285581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10473 OLD HAMMOND HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168264",
            "telephone_number": "225-924-1910",
            "fax_number": "225-924-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10473 OLD HAMMOND HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168264",
            "telephone_number": "225-924-1910",
            "fax_number": "225-924-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTEGRATED BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODLAKE MANAGEMENT, LLC",
        "enumeration_date": "2017-03-07",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-933-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Psychiatry Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Addiction Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.